posted at 3:01 pm on November 9, 2013 by Karl

The Obama administration is considering a fix to the president’s health care law that would expand the universe of individuals who receive tax subsidies to help buy insurance, an administration source told The Huffington Post.

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According to the administration source, the White House is “looking at an administrative fix for the population of people in the individual market who may have an increase in premiums, but don’t get subsidies.”

Even liberal pundits like Paul Waldman wonder how the Administration does this without Congress. True, Obama has not considered the Constitution to be much of a constraint in other situations. On the other hand, exploding the projected cost of O-care subsidies from $458 billion to $1.2 trillion in just the first six years might be difficult to pull off with a wave of the administrative wand.

Yet the most interesting thing about this trial balloon is the extend to which it does not fix what you would think the Left would consider the problem with O-care subsidies. The proposal could be a purely unserious political feint which tries to put the GOP in opposition to decreasing O-care’s pain (per Waldman’s suggestion), or — like Obama’s “sorry, not sorry” this week — to avoid supporting broader legislative fixes. If not, the Administration may have deeper political concerns in mind.

The policy landscape is fairly well-understood, even across ideological lines. As Avik Roy and the Manhattan Institute crew show, health care premiums are set to increase significantly on average under Obamacare, even after the subsidies are included in the calculations. Moreover, there will be distinct winners and losers under this scheme. Men, particularly young men, will tend to be losers. Young women and those approaching retirement age will tend to benefit. TNR’s Jonathan Cohn does not directly dispute much of this analysis. Rather, he relies on experts suggesting O-care will produce more winners than losers, “as long as you account for subsidies, Medicaid, and the ability of young adults to enroll in special catastrophic plans or stay on their parents’ policies,” particularly the Medicaid expansion. These are important qualifiers, as we we will see later.

Cohn continues with perhaps the most salient point:

Of course, the debate about how premiums is just one piece of the story. The ultimate question is whether, under Obamacare, people buying insurance on their own think they are getting a good deal. And the answer to that question will depend on a bunch of factors—not just how much people pay up front in premiums, for example, but also what kind of out-of-pocket costs they face if and when they get sick. And what’s affordable to one person may not seem so affordable to another.

Indeed. Accordingly, it is useful to look at a couple of several examples provided by heath industry consultant Robert Laszewski, based on fairly typical figures from California for the mid-range “Silver” plans to which subsidy levels are tied:

A single person making $22,980 per year would face a premium, net of subsidies, of $121 per month. That’s pretty good.

However, the point most people have been missing is that same person would also face a $500 deductible and up to $2,250 in out-of-pocket costs for things like co-pays. If the individual were sick, that looks like a pretty good deal. If they were healthy, would they spend what is perhaps 10% of their monthly take home income for a plan with an upfront $500 deductible?

***

For so many individuals and families, 10% of their take home income is a huge issue. This is the marginal income left at the end of the month, after taxes, rent, and car payments that is so critically important to them. As purely an insurance value, it’s a good deal. But the notion that hard earned and important dollars would be spent for something they aren’t going to get any measureable short-term value for is another matter entirely.

***

A family at 300% of the federal poverty level will make $71,000 and have to pay out 9.5% of their income for premium, or $6,700 a year for that second-lowest cost Silver plan. How many families making even this much have an extra $558 a month in their budget to buy a plan with a $2,000 per person deductible?

At The Guardian — no right-wing outlet — Marc Rubin notes the same problem with respect to the low-end “Bronze” plans:

The cost alone of these “low end” policies are producing sticker shock when people see them. It gets worse when people see what the insurance companies are actually offering for these premiums. That’s when they get the second shock.

Many uninsured are finding that the bronze or lowest end policies are being priced in the range of $250 a month and up on average and that they come with $6,000 yearly deductibles(pdf) to be paid out of pocket before they get full coverage. Until then, they pay 40% in co-pays until the $6,000 out-of-pocket is reached in addition to the monthly premiums. And again, this is for the bottom tier polices for a single person, not a family. Costs to a family are higher.

It doesn’t take Warren Buffet’s financial savvy to figure out that young, healthy uninsured Americans, who are largely uninsured because they cant afford health insurance in the first place, are not going to be flocking to buy these policies for the privilege of having a health insurance card in their wallets that requires another $6,000 out-of-pocket before their expenses are fully covered and includes co-pays of 40% of all initial costs until that $6,000 is reached. What most of them will do is what they have been doing – live without insurance and go to an emergency room if they need medical care where the law says they have to be treated whether they have insurance or not.

As Laszewski notes, the problem with the subsidies results in part from the fact that the Democrats wanted to price Obamacare at below $1 trillion for political reasons. We have already seen the establishment media begin to report on the degree to which the implementation of O-care — though Healthcare.gov — was compromised by political considerations. We have yet to see much revisiting the degree to which politics warped the creation of the policy itself. Jay Cost has been tweeting about it, and the many times progressives have done it in the past.

Politics also would appear to be the motivating factor behind the Administration’s latest trial balloon. As Byron York noted earlier this week, “[t]he key to Obamacare’s success or failure — provided the administration can actually learn to operate the system — is whether it helps more people than it hurts, or hurts more people than it helps.” I would slightly amend that argument. The key is whether the Administration, and Democrats in general, have a net gain politically.

Progressives see a net gain, but not just on the subsidized voter — they rely on those getting Medicaid (to the extent Medicaid actually helps) and young people staying on their parents’ plans. But the younger and poorer population is also less likely to vote than the older, healthier and wealthier. Providing subsidies to people with incomes higher than 400% above poverty may help stabilize a risk pool currently being filled mostly by the Medicaid expansion. However, as subsidizing the more affluent does nothing for the people in the examples described above, one might be forgiven for suspecting the Administration is looking to buy off more likely voters who will feel the pains of O-care.

Blowback

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I will not comply because I am a free citizen of the United States, not a subject of its government. I consider non-compliance with this monstrosity and the tens of thousands of pages of regulations that are to be enforced by an unelected bureaucracy, and that have left a gigantic carbon footprint on our environment and the United States Constitution, a duty.

LOL! I feel like Tank McNamara thinking he just saw a popped up fumble out of the corner of his eye.
“Eeeaassy boy. Eeeaasssy. It’s not real. It’s just sarcasm. Snark finesse. Let somebody else take the flag.”

Serious question: What the heck ever happened to Peter Orszag? He was the big WH guy pushing this law, authored all the op-ed pieces and blogs on how much money it would save us, and then after he left the WH continued to write op-eds on the glory of the ACA, including this July when he was writing that delaying the employer mandate would ensure a smooth rollout.

Then, pfft. Radio silence. Why isn’t he writing about the ACA anymore? Where is he? Why isn’t he testifying on what is going on? OK, Sebelius screwed up the website, but this was Orszag’s law more than anyone’s in the WH. Where has he gone all of a sudden?

Well, this latest example of the Divine Exemptions From Royalty expozes very bare the fact PlaceboCare was always about expanding the welfare state and ensuring a taxpayer-funded permanent Rat majority, but mostly a taxpayer-funded permanent Rat majority.

As Byron York noted earlier this week, “[t]he key to Obamacare’s success or failure … is whether it helps more people than it hurts, or hurts more people than it helps.” I would slightly amend that argument. The key is whether the Administration, and Democrats in general, have a net gain politically.

.
Finally, someone is writing about the non-premium part of the insurance contract: deductibles on a per/person basis. Everyone I have spoken to in the last week, minority or non-minority, has been derisive and aghast at the demands of Øbamacare. 100%.
.Employer Mandate! Immediately! Bring on the collapse!

A businessperson who was the guilty of the kind of “you can keep your plan, period” false advertising would be put in jail, or at least fined or seriously reprimanded. Now Obama is pushing a “fix” that would explode Obamacare’s costs, and any pretense that Obamacare was going to lower the deficit was more absolutely criminal false advertising, as this illegal fix would just turn the whole Obamacare into a costly joke that is destroying our economy and health care.

death of a thousand cuts….
ACA is this f’d up long befor the first thermometer has graced some babys bumm…befor the first band-aid was applied to a small cut…befor the lines of ppl waiting to even find a doctor were waited in….befor the first botched operation…befor billions in scams and identity fraud…
then the solution should be simple..
full complete repeal….is the only answer..

Another huge factor is that, by making a public announcement of a “fix” in the works, Obama has essentially frozen the market. No buyers are going to commit themselves, and no insurer is going to come out with updated policies, until they see what unilateral changes Obama is going to make to the regulatory environment. In the free market this is known as the Osborne Effect.

But isn’t there several “free” trips to the doctor? And does the deductible have to be met for “free” contraceptives? I would think that if the premiums were covered by Obamacare taxpayers and the preceding is correct, they’re golden.

Well, with the ‘tech surge’ Obama has already committed himself towards trying to solve the clusterfarkedness of the EpicClusterFark by throwing people and money at the problem.

With that still not ‘solving’ the endemic problems of Obamacare, why is it a surprise that the community organizer so enamored with big government as the solution to all problems would decide to treble down by throwing even more money at the problems.

This is just the monetary corollary of Stalin’s quote, one death is a tragedy, one million is a statistic….. one wasted dollar is a tragedy, one billion wasted dollars is the government solving a problem.

What’s a few more billions when we have a $17.1 trillion national debt and are a trajectory to probably reach $20 trillion when Obama’s term ends in January 2017? The ‘rich’ (top 10%) are ‘only’ paying 70% of all income taxes – they can afford more.

Anyone know if the subsidy under obamacare is a specific amount depending on income or is the difference between the price of the plan and a set value depending on income? agmartin on November 9, 2013 at 3:48 PM

And the “Why won’t the mean Republicans help us fix it?!” narrative begins. Inside of one week, 60% of voters will be screaming for the GOP in Congress to “work with the president to fix it.” From here on out, the mess will be all the Republicans’ fault unless they approve every “fix” the Rodeo Clown suggests.

im going to give you rainbows and puppy dogs..
we’ll all sing songs…hold hands…eat free foods…
paint each others faces…burn some insense…
fly some kites…balloons…i’ll give you all 2500$
healthcare will be free….you can keep your doctor…
you can keep your insurance….you can keep your hospital..
better coverage at less cost…free free free…
dont forget to Register to vote…
and your FREE EBT card is in the lobby…

none of that is the truth..well maybe the FREE EBT card part..

the Impeachment papers should allready be filed..
just ask Nixon or Clinton what happens to a CiC that lies…

If the maximum amount of the insurance premium someone must pay is set by the income why wouldn’t anyone who qualifies for a subsidy for a low cost plan just ignore the prices and pick whatever plan has the most comprehensive coverage? After all its someone else’s money.

The main purpose of ObamaCare is to provide free or low cost health care for “his people” – the permanent (mostly black) welfare class and eventually illegal aliens when they receive their “pathway to citizenship.”

It doesn’t take Warren Buffet’s financial savvy to figure out that young, healthy uninsured Americans, who are largely uninsured because they cant afford health insurance in the first place, …. What most of them will do is what they have been doing – live without insurance and go to an emergency room if they need medical care where the law says they have to be treated whether they have insurance or not.

Regarding both highlighted parts, I would argue that they’re hasty generalizations. I want proof. I’d argue that some actually could afford some kind of policy covering catastrophic and serious ER visits. Obamacare does nothing to steer them into a financially responsible plan. Obamacare goes for soup-to-nuts, which makes it so expensive.

“Putting things in perspective: March 21st 2010 to October 1 2013 is 3 years, 6 months, 10 days. December 7, 1941 to May 8, 1945 is 3 years, 5 months, 1 day. What this means is that in the time we were attacked at Pearl Harbor to the day Germany surrendered is not enough time for this progressive federal government to build a working webpage. Mobilization of millions, building tens of thousands of tanks, planes, jeeps, subs, cruisers, destroyers, torpedoes, millions upon millions of guns, bombs, ammo, etc. Turning the tide in North Africa, Invading Italy, D-Day, Battle of the Bulge, Race to Berlin – all while we were also fighting the Japanese in the Pacific!! And in that amount of time – this administration can’t build a working webpage.”

Wow, that Obama “stash” must be a lot bigger than we thought if he’s got a few hundred billion more dollars just lying around waiting to be doled out by our boy king.

But to quote Hillary: “what difference, at this point, does it make?”

We’re already $16 trillion in debt, with hundreds of trillions more in unfunded liabilities in Medicare, Social Security, etc. And Barry has already shown his utter contempt for the U.S. Constitution and the rule of law, with a supine congress unwilling to challenge his lawlessness.

IRS Sent 655 Refund Checks to Single Address in Lithuania – 343 Refund Checks to Address in Shanghai

Akzed on November 9, 2013 at 4:14 PM

In one situation, one hand didn’t know what the other 654 were doing; in another situation, one hand didn’t know what the other 342 were doing.

I kid you not, I’m still waiting for a 2012 refund of about $500 because the clowns at the IRS misapplied some withholding that I had a large financial institution remit to the IRS from redemption proceeds last year. I received a standard letter in June with instructions to go online blah blah blah. I did so, and to help confirm my identity, one identifying question was a multiple-choice question in which I had to select the make and model of the car that I owned while living at an apartment I leased…20 years ago. And the car I owned at that time was one of the four choices.

The IRS can accumulate that kind of information on me, but can’t scratch its collective heads (or balls) when it’s mailing out hundreds of refund checks to the same addresses–overseas addresses at that?

IRS Sent 655 Refund Checks to Single Address in Lithuania – 343 Refund Checks to Address in Shanghai

Akzed on November 9, 2013 at 4:14 PM

I just heard about this yesterday. I cannot understand how anybody with a computer could allow something like this to happen. It would be insanely simple to check for duplication in addresses. I understand they are incompetent. It the level of incompetence that’s so stunning.

The main purpose of ObamaCare is to provide free or low cost health care for “his people” – the permanent (mostly black) welfare class and eventually illegal aliens when they receive their “pathway to citizenship.”

bw222 on November 9, 2013 at 4:22 PM

And when B talked about people “not having skin in the game”, he was referring to everyone except these people!
Why? Because these are his low information sheep. Fed, bought, and paid for by… wait for it… the people B was always bitch’n didn’t have skin in the game!
Now if you’ll excuse me, somewhere its happy hour.

The main purpose of ObamaCare is to provide free or low cost health care for “his people” – the permanent (mostly black) welfare class and eventually illegal aliens when they receive their “pathway to citizenship.”

There is ample evidence that the plans to be sold on the vaporware exchanges will frequently, perhaps usually, be poorer values than the canceled ones. And the 5% figure is very much a lowball estimate. Among others, it excludes people who’ll lose employer-provided insurance or see it downgraded as a result of ObamaCare’s mandates and incentives, as well as those affected by Medicare cuts.

But for the sake of argument, let’s accept the 5% figure as the number of Americans Obama now acknowledges having victimized with his “If you like your plan, you can keep it” swindle. The U.S. population is just over 317 million (that includes children, but so does the population affected by the ObamaCare cancellations). Five percent of 317 million is just under 16 million people.

Imagine if Bernie Madoff had swindled 16 million people.

No, that doesn’t quite do it justice. Imagine if Bernie Madoff had swindled 16 million people, many of whom never agreed, or had any desire, to do business with him in the first place.

Many uninsured are finding that the bronze or lowest end policies are being priced in the range of $250 a month and up on average and that they come with $6,000 yearly deductibles(pdf) to be paid out of pocket before they get full coverage. Until then, they pay 40% in co-pays until the $6,000 out-of-pocket is reached in addition to the monthly premiums.

Man, these people really don’t understand insurance, which also tells me that they haven’t grasped how truly awful the situation is.

A $6,000 deductible does not mean you pay 60/40 until you reach your $6,000 deductible. A $6,000 deductible means that you pay 100% of the bill until your deductible is reached. After you’ve personally paid out $6,000, then the 60/40 co-pay kicks in. Your expenses are not covered at 100% until your out-of-pocket maximum is reached with your co-pays.

I disagree with all those who think that Obamacare will produce ANY significant number of “winners”!

Those who think that some will be “winners” have not considered the problem of actually GETTING “healthcare”! No doctor will be able to practice medicine if he accepts huge losses for treating Medicaid patients…and nobody is telling them what payment they might receive for other Obamacare patients.

Many uninsured are finding that the bronze or lowest end policies are being priced in the range of $250 a month and up on average and that they come with $6,000 yearly deductibles(pdf) to be paid out of pocket before they get full coverage. Until then, they pay 40% in co-pays until the $6,000 out-of-pocket is reached in addition to the monthly premiums.

What? If someone is going to explain how health insurance works is it too much to ask that they know what they’re talking about?

So when will Hillary Turn on Obamacare? Can she just stay quiet about it for the next 3 years? Does she just stick to Bill’s mend it don’t end it without giving inconvenient details about what mending it might mean?

The fix is just an alternative to the massive liability the government is incurring because of the required cancelations without an working alternative. Do the math if 60million cancelations go out and the present a grievance of 50,000 each wow that alone is 3T dollars plus costs. That a boy Obama.

A misguided policy completely written on the back of political interests? No kidding! The simple logic that, after passing the law, Obama and co would introduce the “you can stay on your parent’s plan until you are 26″, thus eliminating a major block of the people who are supposed to pay for all the older and pre-existing condition people, shows that no logic beyond political one was in effect.

The truth please, just this time could Obama tell the truth.
The government is looking at massive liability here. They forced the cancelation of millions of policies with no working alternative for replacement. Do the math, if 60 million policies ask to sue the Government for 50K each that is 3T dollars plus costs. Total over 6T dollars. It’s that simple. While I’m at it. A warring to congress. For some reason no member of congress has ever had a drinking or drug problem. Could it be they hide it well? In 2015 all medical records will be on line, then the hackers can move in and we will know who has been in rehab, where has biden been for the last month, what is Obama’s health really lik